| Entity Name: | FLORIDA CARE ALF OF AMELIA ISLAND INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 May 2021 (4 years ago) |
| Document Number: | P21000051068 |
| FEI/EIN Number | 87-1046223 |
| Mail Address: | 5944 Coral Ridge Drive, CORAL SPRINGS, FL, 33076, US |
| Address: | 1550 NECTARINE STREET, AMELIA ISLAND, FL, 32034, US |
| ZIP code: | 32034 |
| County: | Nassau |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891363362 | 2021-06-11 | 2021-08-24 | 7432 WILES RD, CORAL SPRINGS, FL, 330672066, US | 1550 NECTARINE ST, FERNANDINA BEACH, FL, 320343030, US | |||||||||||||||||||
|
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| Phone | +1 954-461-7435 |
Authorized person
| Name | MR. JOSEPH V MONDELLI JR. |
| Role | PRESIDENT |
| Phone | 9544617435 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1053704965 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MONDELLI JOSEPH V | Agent | 5944 Coral Ridge Drive, CORAL SPRINGS, FL, 33076 |
| Name | Role | Address |
|---|---|---|
| MONDELLI JOSEPH | President | 5944 Coral Ridge Drive, CORAL SPRINGS, FL, 33076 |
| Name | Role | Address |
|---|---|---|
| Taylor Warren | Chief Executive Officer | 1739 NW 80 Ave C, Margate, FL, 33063 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000126719 | AMELIA SPRINGS ASSISTED LIVING | ACTIVE | 2021-09-22 | 2026-12-31 | No data | 7432 WILES RD, CORAL SPRINGS, FL, 33067 |
| G16000040860 | VICTORIA SPRINGS ALF | ACTIVE | 2016-04-22 | 2026-12-31 | No data | 7432 WILES RD, CORAL SPRINGS, FL, 33067 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-04-19 | 1550 NECTARINE STREET, AMELIA ISLAND, FL 32034 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-19 | 5944 Coral Ridge Drive, 506, CORAL SPRINGS, FL 33076 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000782076 | ACTIVE | 2024-000839-CA-01 | MIAMI-DADE CLERK OF COURT CIRC | 2024-11-06 | 2029-12-13 | $81,152.86 | MERCHANT CAPITAL GROUP LLC DBA GREENBOX CAPITAL, 2200 BISCAYNE BLVD, 2ND FLOOR, MIAMI, FL, 33137 |
| J24000558690 | ACTIVE | 1000001009056 | NASSAU | 2024-08-23 | 2034-08-28 | $ 2,734.50 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-05-07 |
| ANNUAL REPORT | 2024-04-27 |
| AMENDED ANNUAL REPORT | 2023-10-04 |
| ANNUAL REPORT | 2023-04-29 |
| AMENDED ANNUAL REPORT | 2022-05-05 |
| ANNUAL REPORT | 2022-04-19 |
| Domestic Profit | 2021-05-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
